Abstract 13179: Rates and Reasons for Emergency Department Use Among US Adults With Congenital Heart Disease

• Published in: Circulation (New York, N.Y.) Vol. 144; no. Suppl_1
• Main Authors: Hong, Jessica M, Sabanayagam, Aarthi, Harris, Ian S, kouretas, peter, Mahadevan, Vaikom S, Sano, Shunji, Agarwal, Anushree
• Format: Journal Article
• Language: English
• Published: 16.11.2021
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.13179

Abstract only Introduction: The adult congenital heart disease (ACHD) population is growing and highly comorbid, requiring increasing emergency department (ED) use. Data on the rates and characteristics of ED visits can inform appropriate care pathways for ACHD patients. Methods: We performed a retrospective study of 16,946 commercially insured beneficiaries with ACHD in the 2016 IBM MarketScan database. Main outcome measures were rates and types of ED visits. Exposures included age, gender, primary beneficiary status, employment status, ACHD severity, cardiovascular (CV) and non-CV comorbidities. Results: Mean age was 35.2±14.2 years, 48.8% were female, and 30.5% had severe CHD. 21.1% had at least one ED visit (23.0% for severe vs. 20.3% for non-severe CHD, p<0.001) while 8.1% had >1 ED visit. Patients with ED visits were more likely to be ≥40 years old (41.0% vs 39.1%, p=0.035), female (53.4% vs 47.6%, p<0.001), have severe CHD (33.2% vs 30.0%, p<0.001), CV (33.0% vs 21.8%, p<0.001) and non-CV comorbidities (38.2% vs 23.6%, p<0.001), and less likely to be the primary beneficiary (56.6% vs 51.4%, p<0.001) or employed (29.0% vs 25.6%, p<0.001). The top five conditions for ED visits for all ACHD patients were CV (33.9%), followed by symptoms, signs, and ill-defined (25.4%), injury and poisoning (25%), respiratory (20.8%), and nervous system issues (14.5%). Compared to adults with non-severe ACHD, severe ACHD patients had more ED visits for CV (36.5% vs. 32.6%, p=0.023) and respiratory conditions (24.0 vs. 19.2%, p=0.001). Variables independently associated with ED visits are listed in the table. Conclusions: One in five ACHD patients had an ED visit, with cardiac and respiratory conditions being more common among adults with severe than non-severe ACHD. Our findings about the factors associated with ED visits provides information about potential interventions and care pathways that might help reduce the burden of ED visits in this high-risk population.